Heppner Gazette-Times, Heppner. Oregon Wednesday, October 1,2008 - SEVEN
State’s smallest hospital faces challenges, tackles expansion lone students learning
Editor’s Note: This article staff (30-some at the hospi nursing services, also heads hospitals have specialists
ran in the September is tal, many with shared duties up home health and hospice, doing. But most don’t want through experience
sue o f the online magazine w ith the H ealth D istrict, and is a backup nurse in the to have janitorial duties also,
or to live an hour from the
which employs 70 full time). emergency room.
CareNews.
From the hill on the
east side of Heppner, Pio
neer Memorial Hospital has
a birds-eye view o f the Mor
row County seat.
Molly Rhea, director
o f nursing services, looks
out of the glassless window
frame on the hospital’s south
side. From here, you can see
most o f the town and most
o f the homes for its 1,400
residents.
Right down there,
she says, a few blocks from
the courthouse, is the house
where she grew up. On that
hill over there, a little west
and north o f downtown, is
the high school she attended
before going away to nurs
ing school.
You can’t see it from
this window, but just south
o f town and slightly east
is Willow Creek Dam, the
w o rld ’s first ro ller-co m
pacted concrete dam. And
just outside the window of
M olly’s office on the floor
below, a fam ily o f quail
g ath ers on the law n for
lunch. These windows will
give a nice view for the
residents and staff when the
new seven-bed long-term
nursing wing is finished.
Once home to a 32-
bed nursing home, this wing
o f the hospital closed in
2003 after years o f losses.
The Morrow County Health
D istrict, which owns and
operates the hospital, is re
building the wing with eight
beds for the nursing home
that can do double duty
as licensed hospital beds.
The designation will bring
the district a higher rate of
compensation.
“ We w o n ’t b reak
even, but w e’ll be within
$ 4 0 ,0 0 0 ,” says H ospital
Administrator Victor Vander
D oes. “ B efore w e w ere
anyw here from $200,000
to $400,000 o f losses every
year.”
T he new n u rsin g
wing is a bright spot and a
source o f pride for Victor,
M olly and the rest o f the
Sheriff’s Report
The Morrow County
Sheriff’s Office reports han
dling the follow ing busi
ness:
July 8 cont.: -BPD
issued a citation to Sebastian
Ramirez Bernal, 24, for no
operator’s license and driv
ing uninsured.
-BPD issued a cita
tion to Leobardo O rozco
Vivian, 21, for no opera
tor’s license and obstructed
window.
-BPD arrested M i
chael Wayne Hoston, 38, for
driving while suspended.
-BPD received a re
port from a caller that there
are kids on bikes going out
into traffic.
-BPD received a re
port from a caller that while
he was in the hospital he
residence was broken into,
his cell phone and some cash
were missing.
-BPD received a re
port that a male subject is
giving rivers inappropriate
hand signals to vehicles on
the freeway.
-B P D a r r e s t e d
Dustin Reed Harper, 32, for
driving while suspended.
-BPD received a re
port from a caller that there
are 4 or 5 kids that are
jum ping on the hood o f a
car and driving around with
their feet.
-MCSO received a
report of a fire on the upper
end o f Big Butter Creek. The
»
But the wing also demon
strates the challenges o f op
erating a hospital in a town
small enough that you can
point out all the landmarks
from a single window.
Small town pluses...
In many ways, there
are advantages to living in
a small town. A five-minute
commute all the way across
town certainly is worthy o f
envy. And it’s nice to be able
to greet every person on the
street by name.
“I think we have to
be m ore p o lite, because
we see th ese people all
the tim e,” says M olly, a
lifelong Heppner resident
w ho gained her big-city
experience while studying
nursing at Portland’s Good
Samaritan Hospital.
And the old axiom
about being considered a
newcomer for the first 30
or 40 years o f residency
doesn’t quite hold up like it
used to, she says.
“We’re quick to wel
come you because we need
more people,” Molly says.
Having new people means
some o f the burdens of com
munity can be shared.
Take Molly and her
husband. Steve is a d e
s c e n d e d o f Oregon Trail
pioneers and an insurance
agent. H e’s been on the city
budget committee, is Hep-
p n er’s volunteer assistant
fire chief and for weeks this
summer was in California
w orking as a firefighter.
M olly is the L ion’s Club
secretary, is active at the
Methodist Church, used to
be a coach and still yells
encouragem ent from the
sideline.
...and small hospital chal
lenges
At the hospital, ev
eryone pulls double, triple,
even quadruple duty.
The adm inistrator,
Victor Vander Does, some
times works as a volunteer
ambulance driver (usually
on St. P a tric k ’s Day, he
says). Molly, the director of
“Some days, when
you get busy, all your plans
for big projects just have to
be pushed aside,” she says.
In lieu o f a security
staff, nurses keep an eye on
the monitor that acts as a
security system.
T h a t’s som etim es
an advantage. Just from
that single glimpse on the
m onitor, many tim es the
nurse will recognize who’s
coming in for urgent care,
know what crop they were
bringing in that day and
what pulled muscle is likely
to be the diagnosis.
More often, the small
tow n presents real c h al
lenges for services, structure
and staff, Victor says. So the
hospital makes adjustments
and makes do.
Pioneer M em orial
no longer does surgeries or
handles childbirth. There
weren’t nearly enough sur
geries and births to keep
obstetricians, surgeons and
anesthesiologists busy, so
they had to drive in from
H erm iston or Pendleton.
Now surgical patients and
mothers in labor make that
hour-long trip in the op
posite direction. But in the
space left vacant by these
services, the hospital now
houses adm inistration as
well as a CT scanner and
digital X-ray. That means
fewer trips out of town for
trauma patients to follow up
on suspicious neck injuries
or possible skull fractures.
Just like reopening the long
term nursing wing means
families won’t have to travel
out o f town for visits.
S iz e d e f i n i t e l y
makes a difference when
it comes to finding staff,
Molly says.
“ I try to play the
small town up as a good
thing, but finding qualified
people is hard,” she says.
M any n u rse s, for
example, enjoy the profes
sional challenge o f handling
additional duties that large
nearest movie theater and
other cultural niceties.
A lot o f times, the
best place to find people is
right at home, Molly says.
There are other home-town
kids like her w ho’ve gone
off to school but want to
come home. And there are
relatives of people already
on staff.
“ We do OK with at
tracting providers,” Victor
says. Two new doctors came
on board just in the last year:
Betsy Anderson, MD, came
from Corvallis, and Russell
N ichols, MD, came from
John Day. Both are primary
care and emergency room
physicians.
But many physicians
spend only a few years, hav
ing signed on to a federal
program that places physi
cians in rural communities
in exchange for reduced
debt for medical school.
O nce th eir o bligation is
complete, many will move
on.
Quality improvement in
small town practice
Medical care in the
United States is under tre
mendous pressure to reduce
costs and improve quality.
T hat’s where some o f the
greatest challenges lie for
rural hospitals.
“ My frustration is
that we have so many re
quirements and there are so
few o f us,” Molly says.
It would be nice if
there were enough staff to
have someone who could
do infection control as their
primary duty.
It would be nice to
have electro n ic m edical
records so that medical rec
onciliation wouldn’t be such
a difficult issue.
It w o u ld be nice
if the director o f nursing
services/home health and
hospice director didn’t also
have to be the quality im
provement department.
But then it wouldn’t
be a small hospital.
fire was determined to be in
the Pilot Rock district.
-MCSO received a
report from a caller in Hepp
ner that there was a fire. The
small fire was put out.
-Irrigon ambulance re
ceived a report that a
mother fell.
July 9: -MCSO re
ceived a report from a caller
in Irrigon requesting extra
patrol due to semi trucks and
10 wheelers traveling fast up
and down the road.
-MCSO received a
report from a caller in lone
that two o f his antique gas
pumps had been stolen.
-BPD received a re
port from a caller that there
was a vehicle in the grass at
a rest area. A deputy made
contact and advised him to
move the vehicle.
-M C S O d e p u ty
helped to assist a subject in
starting there vehicle due to
the battery being dead.
-M CSO received a
report from a caller in Irrig
on that her kids had been bit
by the neighbor’s dog. The
caller made contact with the
neighbor’s and asked them
to take care o f the problem,
but they refused to do any
thing about it.
-BPD received a re
port from a caller that heard
two gun shots.
-MCSO received a
report from a caller in Irri
gon that there were a bunch
of kids up by the river with a
bon fire and possibly drink
ing.
-BPD received a re
port from a caller that there
is som eone doing c o o k
ies for about five minutes
and would like someone to
check it out.
-B P D a r r e s t e d
Shaw na Faye H ahn, 38,
for unlawful possession of
m etham phetam ine. Sub
ject was lodged at Umatilla
County Jail.
-BPD arrested Ed
w ard C harles M cG innis,
41, for unlawful possession
o f methamphetamine. Sub
ject was lodged at Umatilla
County Jail.
-BPD arrested M i
chael Anthony Mullikin, 24,
for criminal mischief. Sub
ject was lodged at Umatilla
County Jail.
-B oardm an am bu
lance received a call from
a male subject that said his
wife is sick, but the wife
says she is fine and did not
want them to respond.
-Irrigon Fire Depart
ment received a report that
there was a fire near the
grain elevators. The fire
Department was unable to
locate the fire in that area.
-Irrigon Ambulance
received a report from a fe
male caller that her 80 year
old grandmother is having
some sort o f a reaction to
some medications.
July 10: -M C SO
received a report that there
was a motorcycle accident
involving a male subject
with a broken ankle.
-M CSO issu e d a
citation to Phillip A rthur
Pringle, 52, for violation of
the basic rule for 73 mph in
a 55 mph speed zone.
-MCSO received a
report from a caller that
there was a vehicle driving
up and down the beach. The
subject(s) left a bunch of
beer cans and a fire burn
ing.
-MCSO received a
report from a caller in Hep
pner that said someone had
left several horses in the pen
at the fairgrounds without
food and w ater and was
wondering if someone had
called in to say they were
leaving them there.
-MCSO received a
report from a caller in Hepp
ner that a male subject came
in and was very upset and
making statements concern
ing his neighbor's home.
-MCSO received a
report from a caller in Herm
iston that advised that there
was a truck that was driving
all over the road.
-BPD issued a cita
tion to Luis Gerardo Cade
nas Nunez, 21, for violation
o f the basic rule.
-MCSO issued a ci
tation to a female subject
for violation o f the speed
limit o f 48 mph in a 35 mph
speed limit.
-MSCO received a
report from a caller in Irri
gon advising that the trucks
g o in g up and down the
road are causing severe dust
problem s and would like
them to spray the road or use
a different access road.
Photos Top to Bottom: Alex Fetteroff is intent on knot tying. Lo
ren Heideman helps Cory Peterson and Alex Kietmann tie knots.
Gunner Jessen gets a knot tying lesson from Loren Heideman.
Kristi C rowell talks about proper pony care w hen handling carts.
In the background are students (L-K)J.I Dixson. Dennis Schmidt,
Tanner Kietmann, Brianna Peterson and Hailey Arbogast. Dennis
Schmidt and Tom Holland learn proper grooming techniques from
guest presenter. Tori Rice. -ContributedPhotos
Students in the lone
C om m unity School a n i
mal science class got some
hands on experience this
past week during the middle
of their horse unit.
Tori Rice, one o f
the guest presenters, helped
students get acquainted w ith
type of gaits horses have, the
difference between horse,
m ules and donkeys, and
what training can do for a
horse. Rice, w ith the help of
friends, Kristi Crowell and
Sharon Woodside, showed
off their cart ponies, walked
stu d en ts through proper
h o o f care and groom ing
techniques and the different
types o f saddles used. “ It
was pretty cool seeing how
they trained animals,” said
senior, JJ Dixon.
“ I re a lly like the
-Continued on Page NINE
miniature donkeys,” com
I
mented senior, Cory Peter
son. "We appreciated getting
to go on a field trip.”
In another unique
opportunity students were
able to experience was knot
tying. Local farmer and boy
scout Loren Heideman dem
onstrated a number o f differ
ent knot tying techniques.
“They are skills students
can use to tie a horse or tie a
load,” said Heideman.
The animal science
class is starting their year
with a horse unit and will
progress through all the
other major livestock units
in addition to a small animal
unit, nutrition, inoculation,
reproduction and ethics and
rights. Anyone interested in
being a presenter or provid
ing a field trip opportunity
is encouraged to contact
instructor, Erin Heideman.